| NPI | 1073691473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: WA PO00000496) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WA PO00000496) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-06-21 |